RESUMO
The therapy for heart failure in patients with uncompromised systolic ventricular function (HfpEF) is still challenging because there is an obvious lack of effective therapy options. Several of these particular patients are additionally presenting atrioventricular (AV) block. In these patients HIS bundle pacing could be a hopeful therapy strategy due to the option of an AV resynchronisation as illustrated in the following case.
Assuntos
Bloqueio Atrioventricular , Fascículo Atrioventricular , Insuficiência Cardíaca , Estimulação Cardíaca Artificial , Eletrocardiografia , Humanos , Volume SistólicoRESUMO
The effects of an outhospital cardiac rehabilitation program in "heart groups" (HG) are studied in a case-control design. The control group (KG) was collected by match-pairing from 12,560 cases of a rehabilitation clinic fitting in the relevant criteria to those of members of the HG. Patients of both groups (n = 75/group) after myocardial infarction and CABG were followed up over 7.5 years. There was no significant difference in risk factor modification. Exercise tolerance improved significantly in the HG by increasing maximum work capacity by 50% in spite of a mean age of 60 years at the beginning. Members of HG had significantly lesser cardiac complaints and lower need for cardiac medication. Cardiac morbidity was reduced by 54% and costs for medical care were lowered by 47% in HG. Although effects of secondary prevention on reducing risk factors were still insufficient, exercise tolerance in higher age and quality of life were improved, reduction in medication and in the morbidity saved costs for the health system.